crossing96/oncoscreening huggingface dataset:
Critical analysis of complications after robotic-assisted radical cystectomy with identification of preoperative and operative risk factors.	OBJECTIVE: To better characterize short- and long-term complications in patients after robotic-assisted radical cystectomy (RRC) using standardized complications-reporting systems, and to identify preoperative and operative risk factors predicting their occurrence. PATIENTS AND METHODS: Data were collected for 79 consecutive patients with bladder cancer undergoing RRC with extracorporeal urinary diversion by one surgeon at our institution. Complications occurring < or =90 days after RRC were graded according to two standardized reporting methods (Memorial Sloan Kettering Cancer Center and Modified Clavien), and additionally stratified by organ system. Nineteen preoperative and operative variables were tested by univariate analysis for association with the occurrence of one or more postoperative complications. Variables with a significant (P < 0.05) or near-significant (P < 0.20) association on univariate analysis were included in multivariate analysis to identify independent risk factors. RESULTS: Patients were of relatively poor health, with 58% having an American Society of Anesthesiology class or Charlson Index score of > or =3. Advanced bladder disease was frequent (41% had pT3/pT4). After RRC, one or more complications occurred within 90 days of surgery for 39/79 (49%) patients. The vast majority of complications were low grade (79%), and mostly infectious (41%) or gastrointestinal (27%). Sixteen high-grade complications occurred in 13/79 (16%) patients. Urinary obstruction, abscess, enteric fistula, gastrointestinal bleeding and thromboembolism constituted most of the high-grade complications, nearly half (seven of 16) of which occurred 31-90 days after RRC. On multivariate analysis, only preoperative renal insufficiency and intraoperative intravenous (i.v.) fluids of >5000 mL were significantly associated with postoperative complications of any grade, with respective odds ratios (ORs) of 4.2 and 4.1. For high-grade complications, significant independent risk factors included an age of > or = 65 years, operative blood loss of > or =500 mL and intraoperative i.v. fluids of >5000 mL, with respective ORs of 12.7, 9.7 and 42.1. CONCLUSION: Even among relatively sick patients with frequent advanced disease, the vast majority of complications after RRC are low grade. High-grade complications are infrequent and similar in nature to high-grade events after open RC, and a notable proportion may occur at >30 days after RRC underscoring the importance of longer reporting intervals. The surgeon's ability to limit blood loss and i.v. fluids during RRC may provide effective risk reduction, particularly for high-grade events.	bladder
Synergistic potentiation of interferon activity with maitake mushroom d-fraction on bladder cancer cells.	OBJECTIVE: To examine whether the combination of interferon (IFN)-alpha and maitake mushroom D-fraction (PDF), a bioactive mushroom extract, might potentiate the anticancer activity of IFN-alpha in bladder cancer T24 cells in vitro. MATERIALS AND METHODS: Effects of recombinant IFN-alpha(2b) (0-50 000 IU/mL), PDF (0-700 microg/mL), or their combinations were assessed on T24 cell growth at 72 h. Cell cycle analysis and assays for double-stranded DNA-dependent protein kinase (DNA-PK) were performed to explore possible antiproliferative mechanism of these agents. RESULTS: IFN-alpha(2b) was able to induce a significant ( approximately 50%) growth reduction at 20 000 IU/mL, which further declined to approximately 66% at 50 000 IU/mL. PDF had no effects up to 200 microg/mL, but there was an approximately 20% and approximately 53% growth reduction at 400 and 700 microg/mL, respectively. When the varying concentrations of IFN-alpha(2b) and PDF were combined, 10 000 IU/mL of IFN-alpha(2b) combined with 200 microg/mL of PDF resulted in an approximately 75% growth reduction. This was accompanied by a G(1) cell cycle arrest, shown by cell cycle analysis. Concurrently, DNA-PK activity in IFN-alpha(2b)/PDF-treated cells was almost three-fold higher than controls. CONCLUSIONS: The combination of IFN-alpha(2b) (10 000 IU/mL) and PDF (200 microg/mL) reduced growth by approximately 75% in T24 cells. This appears to be due to a synergistic potentiation of these two agents, inducing a G(1) arrest with DNA-PK activation. Therefore, the IFN-alpha(2b)/PDF combination could trigger DNA-PK activation that may act on the cell cycle to cease cancer cell growth.	bladder
9p21 index as estimated by dual-color fluorescence in situ hybridization is useful to predict urothelial carcinoma recurrence in bladder washing cytology.	Recent studies have shown that chromosome 9p21 locus is frequently deleted in the early stages of urothelial carcinogenesis. To study the predictive value of the 9p21 aberrations in recurrence of urothelial carcinoma of the urinary bladder, we applied dual-color fluorescence in situ hybridization for 9p21 and chromosome 9 centromere to the bladder washing cytology samples that were obtained from the patients with urothelial carcinoma of the urinary bladder treated by transurethral resection. For the evaluation, the 9p21 index was defined as the ratio of the mean number of 9p21 signals per nucleus for that of the chromosome 9 centromere signals per nucleus in each of the bladder washing cytology samples. The 9p21 index values of the bladder washing cytology samples with no (G0) cytologic atypia were significantly higher than those of the bladder washing cytology samples with moderate (G2) (P < .01) and severe (G3) (P < .001) cytologic atypia, but the index values did not statistically differ from those of the bladder washing cytology samples with mild (G1) cytologic atypia. Recurrence-free survival in the patients with a low 9p21 index value (<0.9) was significantly poorer in comparison with the patients with a high 9p21 index value (>0.9). Furthermore, 2 patients of bladder washing cytology G1 with a low 9p21 index value recurred much sooner than the other patients of the bladder washing cytology G1 category. These findings indicate that a decreased 9p21 index value is associated with recurrence of urothelial carcinoma of the urinary bladder, and the 9p21 index may be useful as a marker to identify patients with elevated risk of recurrence of urothelial carcinoma of the urinary bladder.	bladder
Nitrofurantoin-induced systemic inflammatory response syndrome.	Nitrofurantoin is a commonly used antibiotic for the prophylaxis and treatment of urinary tract infections. We report the first case of nitrofurantoin-induced systemic inflammatory response syndrome, an important adverse drug reaction in the setting of what was initially believed to be a recurrent infection.	bladder
Primary urothelial carcinoma of the upper tract: important clinicopathological factors predicting bladder recurrence after surgical resection.	The aim of the present study was to further characterize potential clinicopathological predictors for urinary bladder recurrence-free survival (UBRFS) in patients with primary urothelial carcinoma of the upper urinary tract (UUT-UC). The present series included 385 cases of surgically treated primary localized UUT-UC without previous or concurrent urothelial carcinoma of the urinary bladder. Among the 374 patients with follow-up information, clinicopathological features and therapeutic information including whether they received a laparoscopy-assisted nephroureterectomy (LNU) and adjuvant chemotherapy were correlated with UBRFS. After a median follow up of 69 months, 86 patients (23%) developed urinary bladder recurrence. The median time to develop urinary bladder recurrence was 12 months. At the univariate level, an increment in histological grade (P= 0.0321), a prominent papillary configuration (P= 0.0004), LNU (P= 0.0397) and male gender (P= 0.0401) significantly predicted an inferior UBRFS. At the multivariate level, increase of histological grade (P < 0.0001, relative risk (RR) = 3.776), prominent papillary configuration (P < 0.0001, RR = 3.244), and male gender (P= 0.0463, RR = 1.444) independently predicted UBRFS. In conclusion, male patients and those with high-grade and papillary UUT-UC, and who received LNU had higher risks of urinary bladder recurrence. Accordingly, for these patients, more intensive follow up coupled with postoperative intravesical adjuvant therapy to prevent urinary bladder recurrence should also be considered.	bladder
Predicting recurrence and progression in non-muscle-invasive bladder cancer using European organization of research and treatment of cancer risk tables.	INTRODUCTION: We determined the recurrence and progression at 1 year in patients with non-muscle-invasive urothelial carcinoma who underwent transurethral resection of bladder tumor (TURBT) and compared those with the calculated risk according to the European Organization of Research and Treatment of Cancer (EORTC). MATERIALS AND METHODS: Follow-up data of 92 patients with non-muscle-invasive bladder cancer who underwent TURBT were reviewed, and their 1st year recurrence and progression were recorded. The risk of recurrence and progression were calculated for 1 year according to the EORTC scoring system, using tumors' stage, grade, size, and multiplicity, and the presence of carcinoma in situ and previous recurrence episodes. The outcomes were compared with the EORTC's predictive scores. RESULTS: The patients were 75 men and 17 women with an age range of 31 to 91 years. Sixteen patients (17.4%) had a recurrent disease, 41 (44.6%) had a tumor larger than 3 cm in diameter, 35 (38.0%) had multiple lesions, 2 (2.2%) had carcinoma in situ, 73 (79.3%) had stage T1 lesions, and 8 (8.7%) had a high-grade disease. Recurrence was found in 34 patients (37.0%). The recurrence rates were 20.0%, 28.2%, 40.5%, and 83.3% in groups with the predicted EORTC risks of 15%, 24%, 38%, and 61%, respectively. There were 2 patients (2.2%) with progression of the diseases. CONCLUSION: A significant concordance was noted between the EORTC's calculated risk and the recurrence rate of stage Ta T1 bladder cancer at 1 year. Progression was less than that predicted, probably due to our small sample size.	bladder
Palliative treatment of intractable hematuria in context of advanced bladder cancer: a systematic review.	INTRODUCTION: In a patient with bladder urothelial cancer that is not suitable for or does not choose curative treatment, intractable hematuria is a disastrous condition. In this article, we tried to review the literature and extract a stepwise approach for palliative treatment of hematuria in these patients. MATERIALS AND METHODS: The MEDLINE was searched with the help of the Medical Subject Headings system using different combinations of terms urinary bladder neoplasm, hematuria, carboprost, cyclophosphamide, cystitis, alum, and hyperbaric oxygenation. The articles were separately reviewed by the two authors and verified by each other. Eventually, a decision tree was developed for management of gross hematuria in patients with bladder cancer. RESULTS: Although, there was not any reported randomized controlled trial or prospectively designed study, the available case series were rather expressive to draw out a logical approach. Formalin has a grave adverse effect profile and recommended only in special circumstances. For management of each case of gross hematuria in bladder cancer, the etiology of bleeding is the most important determinant. CONCLUSION: Hematuria in the context of advanced bladder neoplasms can now be effectively treated with fewer side effects using all available modalities in a logical holistic approach. We proposed a decision tree for management of hematuria in this context. However, regarding lack of well-designed trials, a treatment method should be based on individualized scenarios and clinical experience, bringing into account the patient's preferences.	bladder
Lead concentration in the bladder tissue and blood of patients with bladder cancer.	OBJECTIVE: To investigate the relationship between lead and bladder cancer. MATERIAL AND METHODS: The levels of lead concentration in blood and bladder cancer tissue from a sample set of 36 bladder cancer patients were measured and then compared with those of a normal group. The levels of lead obtained in the bladder cancer tissue were evaluated depending on the stage of the tumour. The level of lead concentration in each tissue sample was determined by atomic absorption spectrometry. RESULTS: The lead concentration reached statistically higher values in both the bladder cancer tissue and the blood of patients with this carcinoma compared with those of the control group. No relationship between lead concentration levels in the bladder cancer tissue and blood of patients with this neoplasm on stage of tumour was demonstrated. CONCLUSION: The results suggest that there is a relationship between exposure to lead and the initialization and development of bladder cancer.	bladder
[Confocal laser scanning microscopy of the urothelium].	In order to improve the detection of flat urothelial neoplasia an improvement in optical methods might be helpful. We investigated the use of confocal laser scanning microscopy in a pilot study of specimens with bladder cancer. A total of 35 fresh ex vivo specimens of 20 human bladders of patients who underwent radical cystectomy were examined with a modified confocal laser scanning microscope (670 nm). The field size was 200x200 microm and tissue was investigated up to depths of 120 microm. Resulting data sets were reconstructed three-dimensionally by computer software. Results were compared with conventional histology. Microscopically diseased bladder mucosa showed cytological and histological criteria of malignancy which were readily identifiable by laser scanning microscopy. In all cases we were able to detect the presence of malignancy with the images generated by the confocal laser scanning technique. Atypical cellular structures and subepithelial hypervascularization were prominent features. Carcinoma in situ lesions could also be identified in many cases. Confocal laser scanning microscopy allows the analysis of cellular and epithelial architecture of the urothelium in a detail which is beyond the limitations of conventional endoscopy by white light cystoscopy. Therefore, the principle would probably be of benefit if the technical limitations can be overcome.	bladder
Persistence of DNA damage following exposure of human bladder cells to chronic monomethylarsonous acid.	Malignant transformation was demonstrated in UROtsa cells following 52-weeks of exposure to 50 nM monomethylarsonous acid (MMA(III)); the result was the malignantly transformed cell line, URO-MSC. URO-MSC cells were used to study the induction of DNA damage and the alteration of DNA repair enzymes in both the presence of MMA(III) [URO-MSC(+)] and after subsequent removal of MMA(III) [URO-MSC(-)] following chronic, low-level exposure. In the presence of MMA(III), URO-MSC(+) cells demonstrated a sustained increase in DNA damage following 12-weeks of exposure; in particular, a significant increase in DNA single-strand breaks at 12-weeks of exposure consistently elevated through 52 weeks. The persistence of DNA damage in URO-MSC cells was assessed after a 2-week removal of MMA(III). URO-MSC(-) cells demonstrated a decrease in DNA damage compared to URO-MSC(+); however, DNA damage in URO-MSC(-) remained significantly elevated when compared to untreated UROtsa and increased in a time-dependent manner. Reactive oxygen species (ROS) were demonstrated to be a critical component in the generation of DNA damage determined through the incubation of ROS scavengers with URO-MSC cells. Poly (ADP-ribose) polymerase (PARP) is a key repair enzyme in DNA single-strand break repair. URO-MSC(+) resulted in a slight increase in PARP activity after 36-weeks of MMA(III) exposure, suggesting the presence of MMA(III) is inhibiting the increase in PARP activity. In support, PARP activity in URO-MSC(-) increased significantly, coinciding with a subsequent decrease in DNA damage demonstrated in URO-MSC(-) compared to URO-MSC(+). These data demonstrate that chronic, low-level exposure of UROtsa cells to 50 nM MMA(III) results in: the induction of DNA damage that remains elevated upon removal of MMA(III); increased levels of ROS that play a role in MMA(III) induced-DNA damage; and decreased PARP activity in the presence of MMA(III).	bladder
Extra-adrenal paraganglioma: presentation in three uncommon locations.	Extra-adrenal paragangliomata are uncommon entities. They can be classified into four basic groups according to their anatomical sites, i.e. branchiomeric, intravagal, aorticosympathetic and visceral autonomic. Similar tumours may arise in sites away from the usual distribution of the sympathetic and parasympathetic ganglia, e.g. orbit, nose, small intestine and even in the pancreas. We report three instructive cases of extra-adrenal paraganglioma which were found in unusual sites such as urinary bladder, thyroid gland and on the wall of the inferior vena cava.	bladder
E-cadherin and p63 immunoexpression in dysplastic lesions and urothelial carcinomas of the bladder.	In this study, we investigated 30 cases of dysplastic lesions and bladder carcinomas. The lesions presented different degree of differentiation and depth of invasion. The aim of this study was to appreciate the immunoexpression of some proteins, like E-cadherin and p63, which are implicated in the cellular adhesiveness and the normal development of the urothelium, depending on the degree of tumoral differentiation and the depth of invasion. The immunoreactivity of the markers was qualitative and quantitative evaluated. Both markers presented an immunoexpression diminishing with depth of invasion, the carcinomas with muscularis propria invasiveness having a minimum intensity reaction (0 or 1), and a medium percentage of marked cells by 10-50% for E-cadherin, and 30% for p63. The immunostaining intensity for E-cadherin decreased with the tumoral degree of differentiation, the poorly differentiated carcinomas having a reaction with minimum intensity (0 or 1). The p63-immunoexpression was correlated with the degree of differentiation in superficially cases of chorion invasiveness carcinoma. The immunostaining intensity in cases with muscularis propria invasiveness was diminished as the number of epithelial layers becomes bigger, but there was no variation depending on tumoral differentiation. In conclusion, E-cadherin and p63 are implicated in tumoral progression and may be used as a prognostic markers.	bladder
Renal transplant recipients and patients with end stage renal disease present with more advanced bladder cancer.	PURPOSE: Renal transplant recipients have an increased incidence of bladder cancer. It is unknown whether these cancers are more aggressive than those in nontransplanted cases and whether this is also true for cases with end stage renal disease without renal transplantation. MATERIALS AND METHODS: Surveillance, Epidemiology and End Results-Medicare data identified 97,942 patients with bladder cancer diagnosed between 1988 and 2002. We compared gender, race, tumor stage and histology at diagnosis among patients with a renal transplant, end stage renal disease or neither condition. The statistical significance of differences in the distribution of patient and tumor variables was assessed using the chi-square statistic (categorical variables) and single factor ANOVA tests of difference in means (continuous variables). RESULTS: Renal transplant recipients (58) were younger at diagnosis than those with end stage renal disease (400) or with neither diagnosis (97,484) (p <0.0001). Muscle invasive disease (stage T2 or greater) at presentation was more common in renal transplant recipients (37%, p = 0.04) and patients with end stage renal disease (33%, p = 0.0001) than in patients without these conditions (24%). Most renal transplant recipients were diagnosed with bladder cancer within 4 years of transplantation. Patients with a renal transplant (17%, p = 0.001) and end stage renal disease (12%, p <0.0001) also had a higher proportion of nonurothelial tumors than the remaining population (6.5%). CONCLUSIONS: Renal transplant recipients and patients with end stage renal disease present with higher stage bladder cancer than those without these conditions despite closer medical supervision. Since most renal transplant recipients were diagnosed with bladder cancer within 4 years of undergoing renal transplantation, consideration should be given to bladder cancer screening of such patients in this period.	bladder
Optical biopsy of human bladder neoplasia with in vivo confocal laser endomicroscopy.	PURPOSE: Confocal laser endomicroscopy is a new endoscopic imaging technology that could complement white light cystoscopy by providing in vivo bladder histopathology. We evaluated confocal laser endomicroscopy by imaging normal, malignant appearing and indeterminate bladder mucosa in a pilot study. MATERIALS AND METHODS: Patients scheduled to undergo transurethral resection of bladder tumors were recruited during a 3-month period. After standard cystoscopy fluorescein was administered intravesically and/or intravenously as a contrast dye. A 2.6 mm probe based confocal laser endomicroscope was passed through a 26 Fr resectoscope to image normal and abnormal appearing areas. The images were collected with 488 nm excitation at 8 to 12 frames per second. The endomicroscopic images were compared with standard hematoxylin and eosin analysis of transurethral resection of bladder tumor specimens. RESULTS: Of the 27 recruited patients 8 had no cancer, 9 had low grade tumors, 9 had high grade tumors and 1 had a low grade tumor with a high grade focus. Endomicroscopic images demonstrated clear differences between normal mucosa, and low and high grade tumors. In normal urothelium larger umbrella cells are seen most superficially followed by smaller intermediate cells and the less cellular lamina propria. In contrast, low grade papillary tumors demonstrate densely arranged but normal-shaped small cells extending outward from fibrovascular cores. High grade tumors show markedly irregular architecture and cellular pleomorphism. CONCLUSIONS: We report the first study to our knowledge of in vivo confocal laser endomicroscopy in the urinary tract. Marked differences among normal urothelium, low grade tumors and high grade tumors were visualized. Pending further clinical investigation and technological improvement, confocal laser endomicroscopy may become a useful adjunct to conventional cystoscopy.	bladder
Retroperitoneoscopic para-aortic lymph node sampling in bladder rhabdomyosarcoma.	Determining lymph node involvement is an important step in the pre-treatment evaluation of non-metastatic rhabdomyosarcoma. We describe retroperitoneoscopy for para-aortic lymph node biopsy in a 4-year-old boy with embryonal rhabdomyosarcoma of the bladder with pelvic and para-aortic lymph node enlargement on magnetic resonance imaging. This technique affords access to the para-aortic region with minimal dissection, permitting quick recovery and early commencement of chemotherapy.	bladder